HELP>>>How do I start..

[MrsBadshoe]

I want to try to get at least Delaney on a Guardian.....I've called the insurance company and the 2 people I've talked to just have no idea...yeah Minimed is in your InNetwork provider it will be covered less deductable...

I'm sure they have no idea what the product is...i've called Medtronic and was told that there currently is no code number though some insurance companies are still covering...

How do I get past the first level of insurance CS reps?????What do I ask for?????

[WestinsMom]

I am wondering the exact same thing! I just spoke with my minimed rep and she said to get a contact person at all insurance companies (ie. primary and secondary). She also said to be specific. If you ask for Contiuous Glucose Monitor it is too broad. In our case she said "Real Time Glucose Monitor" or something like that. I have read elsewhere to sit on the phone next to a fax, so when you have to send them your letter of medical necessity or any other supporting documents that you can fax them right while they are on the phone with you...less phone tag! I will keep an eye on this thread, as I just got our 722 and are ready for the next step!

[EmmasMom]

I started with the predetermination department at the insurance company. I gathered all the info about the device, got a letter of medical necessity, wrote a letter explaining how it would benefit my daughter and their bottom line... etc.
I started faxing all of it to the pre-d department weekly until I heard back from them. The first letter I got back was a denial because of the lack of a billing code. I explained...again, that there was no billing code, and they would have to make arrangements with MM. They finally agreed and then 4+ months later paid the first claim. :rolleyes: -:)

We have been paying upfront for our sensors until this month, UHC now has an agreement in writing with MM that Emma's sensors are covered at 90%, and we can order them anytime w/o paying first.

[MrsBadshoe]

Thanks for the advice.

OK...I've got a name and number to fax stuff too...now with the first time do I fax them all the back up I have or just the basics....I'm afraid that if I send them everything I won't have anything to send for the denial???